Rare Location of Ewing Sarcome: A Case Study

Abstract

Introduction: Ewing's sarcoma is also known as a primary peripheral neuroectodermal tumour and is a primary malignancy accounting for 5-15% of all malignancies. It can involve all skeletal bones and more rarely soft tissue. The area of predilection of this tumour is the long bones 50-60%; the flat bones mainly the pelvis 20%, while the bones of the foot and the hand constitute an exceptional localization (1), hence the interest to report our case. Clinical presentation: We report the case of an 18-year-old girl who presented with a painful swelling of the right heel evolving for 14 months in a febrile context. The diagnosis of Ewing's sarcoma of the calcaneus was suspected by radiological assessment and confirmed by a histological study after a biopsy. We discuss the clinico-radiological and histological diagnosis of this tumour and its management. Discussion: Ewing's sarcoma described by James Ewing in 1921(2), since then Cook reports only 29 cases of Ewing's sarcoma of the calcaneus in the literature (3), which shows the paucity of the literature concerning this type of calcaneal lesions, and therefore clinicians are unfamiliar with these tumours and therefore a delay in diagnosis, morbidity and amputations unnecessary. It is a tumour with a rapid potential for metastasis, particularly in the lungs, which determines the prognosis of this lesion. Conclusion: Ewing's sarcoma remains a rare disease (4) of which the calcaneus is an exceptional location. It may be misdiagnosed with other lesions, notably calcaneal osteomyelitis.